Soft tissue effects of Twin Block and Herbst appliances in patients with Class II division 1 mandibular retrognathy

The purpose was to compare the treatment effects of functional appliances activator-headgear (AH) and Twin Block (TB) on skeletal, dental, and soft-tissue structures in class II division 1 malocclusion with normal growth changes in untreated subjects. The sample included 50 subjects (56% females) aged 8–13 years with class II division 1 malocclusion treated with either AH (n=25) or TB (n=25) appliances. Pre- and posttreatment lateral cephalograms were evaluated and compared to 50 untreated class II division 1 cases matched by age, gender, ANB angle, and skeletal maturity. A paired sample, independent samples tests and discriminant analysis were performed for intra- and intergroup analysis. Treatment with both appliances resulted in significant reduction of skeletal and soft-tissue facial convexity, the overjet, and the prominence of the upper lip in comparison to untreated individuals (p<0.001). Retroclination of maxillary incisors and proclination of mandibular incisors were seen, the latter being significantly more evident in the TB group (p<0.05). Increase of effective mandibular length was more pronounced in the TB group. In conclusion, both AH and TB appliances contributed successfully to the correction of class II division 1 malocclusion when compared to the untreated subjects with predominantly dentoalveolar changes.

Download Full-text

Cephalometric evaluation of the effects of the Twin Block appliance in subjects with Class II, Division 1 malocclusion amongst different cervical vertebral maturation stages

Dental Press Journal of Orthodontics ◽

10.1590/2177-6709.21.3.073-084.oar ◽

2016 ◽

Vol 21 (3) ◽

pp. 73-84 ◽

Cited By ~ 4

Author(s):

Aisha Khoja ◽

Mubassar Fida ◽

Attiya Shaikh

Keyword(s):

Soft Tissue ◽

Class Ii ◽

Post Treatment ◽

Twin Block ◽

Lateral Cephalograms ◽

Division 1 ◽

Maturation Stages ◽

Cervical Vertebral Maturation ◽

Treatment Observation ◽

Class Ii Division 1

ABSTRACT Objectives: To evaluate the cephalometric changes in skeletal, dentoalveolar and soft tissue variables induced by Clark's Twin Block (CTB) in Class II, Division 1 malocclusion patients and to compare these changes in different cervical vertebral maturation stages. Methods: Pre- and post-treatment/observation lateral cephalograms of 53 Class II, Division 1 malocclusion patients and 60 controls were compared to evaluate skeletal, dentoalveolar and soft tissue changes. Skeletal maturity was assessed according to cervical vertebral maturation stages. Pre- and post-treatment/observation mean changes and differences (T2-T1) were compared by means of Wilcoxon sign rank and Mann-Whitney U-tests, respectively. Intergroup comparisons between different cervical stages were performed by means of Kruskal-Wallis test and Mann-Whitney U-test (p ≤ 0.05) . Results: When compared with controls, there was a significant reduction in ANB angle (p < 0.001), which was due to a change in SNB angle in CS-2 and CS-3 (p < 0.001), and in SNA (p < 0.001) and SNB (p = 0.016) angles in the CS-4 group. There was significant increase in the GoGn-SN angle in CS-2 (p = 0.007) and CS-4 (p = 0.024), and increase in Co-Gn and Go-Gn amongst all cervical stages (p < 0.05). There was significant decrease in U1-SN and increase in IMPA amongst all cervical stages (p < 0.05). There was significant retraction of the upper lip in CS-3 (p = 0.001), protrusion of the lower lip in CS-2 (p = 0.005), increase in nasolabial angle in CS-4 (p = 0.006) and Z-angle in CS-3 (p = 0.016), reduction in H-angle in CS-2 (p = 0.013) and CS-3 (p = 0.002) groups. When pre- and post-treatment mean differences were compared between different cervical stages, significant differences were found for SNA, SNB and UI-SN angles and overjet. . Conclusions: The Twin-Block along with the normal craniofacial growth improves facial esthetics in Class II, Division 1 malocclusion by changes in underlying skeletal and dentoalveolar structures. The favorable mandibular growth occurs during any of the cervical vertebral maturation stages, with more pronounced effect during CS-3 stage.

Download Full-text

Perbedaan Analisis Sefalometri Skeletal Sebelum dan Sesudah Perawatan Alat Myofunctional pada Pasien Maloklusi Dentoskeletal Kelas II Divisi I dalam Masa Pertumbuhan dengan Metode Steiner

Majalah Sainstekes ◽

10.33476/ms.v4i2.906 ◽

2019 ◽

Vol 4 (2) ◽

Author(s):

Nugroho Ahmad Riyadi

Keyword(s):

Orthodontic Treatment ◽

Class Ii ◽

T Test ◽

Analytic Study ◽

Statistic Analysis ◽

Twin Block ◽

Normal Occlusion ◽

Division 1 ◽

Before And After ◽

Class Ii Division 1

The aim of orthodontics treatment is normalization of teeth position in three planes, using various orthodontics appliance to reach the chepalometric standar and normal occlusion. Orthodontic treatment for dentoskeletal class II division 1 malocclusion in growing patients using myofunctional appliance may correct anteroposterior planes of mandibula. This study was a descriptive retrospective analytic study to look at the success of Orthodontic treatment for dentoskeletal class II division 1 in growing patients with myofunctional appliance using chepalometrics analysis Steiner value. The sample used in this study is chepalogram radiographic from patient with dentoskeletal class II division 1 malocclusion in growing patients before and after using myofunctional appliance in PPDGS orthodontics Clinic of Padjadjaran University. Statistic analysis were performed with pair t-test and Wilcoxon. Based on this study, it is concluded that orthodontic treatment with myofunctional appliance such as activator and twin block in growing patient with dentoskeletal class II division 1 malocclusion shows significant changes and compatibility with the normal criteria.

Download Full-text